We Can Eradicate Malaria Within a Generation | Hacker News Reader

We Can Eradicate Malaria Within a Generation

gatesnotes.com

183 pointsdsr12103 comments

You have to respect the man's dedication.

He wanted his OS on every desktop computer and he may have played loose with the rules but he got his wish.

Now he wants this terrible disease to be destroyed, and there are a lot of obstacles in his way (and after all, destroying a well entrenched virus is a feat that humanity reached only once before), but still in my heart I feel like I wouldn't bet on the virus on that one.

With the money, prestige, experience and pull that he has he could be anything he wanted, and I for one am glad what he wants is to move humanity forward. Some say his time as CEO is done and now he is only playing the philanthropy game, but when you see talks from B.Gates on the matter it is clear that he is just as driven to that goal as he was during his CEO time, if not more. I think he likes the challenges, it drives him and he is one of the few who can tackle it head on, which ultimately will benefit everyone.

>he may have played loose with the rules ... he is one of the few who can tackle it head on, which ultimately will benefit everyone.

He --may-- have? Let's not whitewash history. He not only very much played loose with the rules, he outright broke the rules and trampled upon laws that caused far-reaching net damage to society in the process.

Like yourself and most others, I'm certainly pleased that Gates has decided to give back a small portion of his overall plunder from society, but it also shouldn't act as a public relations whitewash that erases his past history. His charity doesn't simply erase his overall negative impacts upon society that runs easily into the trillions and also took away from charity by proxy and directly in the process as well for decades.

We should teach future generations to give to charity, but in the process we shouldn't also instruct future generations that the way Gates amassed his ridiculous amount of money and power was acceptable and good for society overall.

Despite what they and their lackeys would have many of us believe, society prospers without megalomaniacal billionaires. Billionaires reach that ridiculous, megalomaniacal status by pushing the externalities produced via their business growth upon the rest of society instead of paying it themselves.

Once externalities are accounted for, there are very few organic, ethical ways to acquire and hoard that kind of wealth without stunting the rest of society in insidious ways. And, by the time one "gives it away", all the greater damage has already been done in the meantime.

We don't need them. For example, the overwhelming majority of charity comes from small businesses and lower income individuals. The same individuals and small businesses that are drastically hurt and destroyed by the business practices of people like Gates and other billionaires.

Keep in mind, large corporations and people like Bill Gates give only a tiny percentage of overall charity, but they (and their lackeys) spend vastly more on telling everyone about it through various public relations channels, etc. and that's why it distorts public perception on who really gives the lion's share to charity overall.

Again, I'm very happy Gates is giving to charity, but let's not whitewash his overall net impact against society in the process. He accomplished some great good for society with his business and now his charity as well. But, for us to ignore all the harm he's caused with his past business practices over those decades isn't fair to society and it's a horrible lesson for future generations that may think they should emulate the methodologies billionaires like him use to acquire and hoard enough wealth to reach that "status".

There's much more to the story of Bill Gates and his dire issues with externalities (and charity issues as well) that we shouldn't ignore in our haste to worship him and/or as someone else in this thread did... apply some sort of sainthood.

edits: spelling/grammar

>doesn't simply erase his overall negative impacts upon society that runs easily into the trillions

Any source on that? I rather enjoyed using his products.

People also enjoy Coke and now they are friends with Type-2 diabetes.

>>doesn't simply erase his overall negative impacts upon society that runs easily into the trillions

>Any source on that?

Here's some:

http://blogs.edweek.org/teachers/living-in-dialogue/2012/07/...

http://newint.org/features/2012/04/01/bill-gates-charitable-...

http://en.wikipedia.org/wiki/Bill_%26_Melinda_Gates_Foundati...?

http://en.wikipedia.org/wiki/Microsoft_litigation

--- (Some homework: Calculate an estimate of all the harm to all these businesses and, by proxy, consumers above)

http://lists.essential.org/1998/info-policy-notes/msg00047.h... (It goes way back)

http://www.aaxnet.com/topics/msinc.html (It keeps going)

http://papers.ssrn.com/sol3/papers.cfm?abstract_id=304701 (download the PDF there)

--- Observe the many examples here:

http://thismatter.com/articles/microsoft.htm#tq1

http://papers.ssrn.com/sol3/papers.cfm?abstract_id=241988 (download the PDF there)

http://papers.ssrn.com/sol3/papers.cfm?abstract_id=502822 (download the PDF there)

http://www.forbes.com/forbes/1998/0907/6205050a.html (FORBES mag)

http://en.wikipedia.org/wiki/Criticism_of_Microsoft#Vendor_l...

--- History of Anticompetitive behavior and consumer harm:

http://unctad.org/en/Docs/ditcclp20082_en.pdf

http://highered.mcgraw-hill.com/sites/dl/free/0072487933/466... (a very enlightening read)

http://www.cptech.org/ms/harm.html

http://www.netaction.org/msoft/world/part1.html

http://www.netaction.org/msoft/world/table.html

http://www.theinquirer.net/inquirer/news/1016972/nvidia-blam...

http://www.cnn.com/TECH/computing/9901/11/microrise.idg/

http://www.infoworld.com/t/platforms/your-loss-their-gain-32...

http://www.fool.com/cashking/1998/cashkingport981118.htm

http://www.kuro5hin.org/?op=displaystory;sid=2001/6/21/61725...

http://www.maxframe.com/DR/Info/fullstory/ca_sues_ms.html

--- Microsoft entered into anticompetitive and exclusionary agreements with OLSs and ISPs:

http://www.justice.gov/atr/cases/f3800/msjudgex.htm#vii

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The effects of anti-competitive business practices on developing countries and their development prospects:

http://unctad.org/en/Docs/ditcclp20082_en.pdf

The Gates Foundation investments include companies that worsen poverty in developing countries, pollute heavily and supports pharmaceutical companies that don’t sell into the developing world.

Also, he’s doing it wrong with malaria.

By pouring most contributions into the fight against such high-profile killers, Gates is diverting staff from basic care. This form of “brain drain”, pulls away trained staff from children and those suffering from other common killers.

The focus on a few diseases has shortchanged basic needs such as nutrition and transportation. Gates-funded vaccination programs have instructed caregivers to ignore – even discourage patients from discussing – ailments that the vaccinations cannot prevent.

The Gates Foundation harms global health by diverting resources from other important local health care services. The foundation diverts medical professionals from other parts of developing nations’ health care systems; the health care systems’ ability to provide care diminishes (except in the area the foundation funds) and the charities do more harm than good. (This has been backed up by several prominent investigations, please look it up)

The Gates Foundation is also undermining public education and exerts too much influence over public education policy without being accountable to voters or tax payers. The reforms include closing neighborhood schools in favor of privately run charter schools, forcing standardized tests which have been proven to harm education (just ask teachers, educational professionals, etc.).

What should we learn from this?

It’s better to have decentralized sources of charity coming from many sources instead of one collective source. Unfortunately, Gates helped to hinder and in many cases completely detroy entities that would have not only given vastly more to charity, but would have also done it in a far more diversified and effective manner.

It’s very ironic.

Bill Gate’s monopoly helped usher in an era of rampant malware for decades because of the lack of platform diversity.

http://cryptome.org/cyberinsecurity.htm

All of this above together cost average consumers and businesses worldwide in the trillions (many of whom were able to give less to charity because of this). Many businesses and consumers were rail-roaded into using subpar products and services via his unethical, anti-competitive, monopolistic business practices.

The sick irony: He’s now using those same ill-gotten profits (that hurts the world in the past, present and future with a lack of diversification) and is giving it to the developing world in an ironically non-diversified manner and hurting them as well.

As Bill Gates was with Microsoft, he’s too arrogant to look at the big picture externalities.

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Typical question I get is to please source small businesses and individuals giving more to charity.

It's not terribly easy to find good sources because Google's search algorithms (which are written basically by editors, by the way) will give precedence to all the multiple, corporate media Public Relations that merely offers deceiving articles about the "Top 10 corporations who give to charity", etc.

For example, this corporatist Public Relations piece:

http://money.msn.com/investing/companies-giving-the-most-to-...

While you're there at that Public Relations piece above disguised as a news article, please read the informative first comment at the bottom about "how to lie with statistics” as well.

Here's the reality with vital externalities at play that a lot of the corporate media would like us all to ignore:

-- Corporate giving accounts for just 5% of the total giving in 2013.

Yes, you read that correctly, just FIVE PERCENT and that's not just an anomaly for 2013. It's always very low compared to everyone else. The vast amount of all charity is given by small businesses and (especially) lower income individuals. Not just a few huge corporations and some billionaires like Gates.

What corporations and billionaires like Bill Gates really do is spend a vast amount of money on Public Relations to advertise the fact that they give money to charity. It creates the public illusion that major corporations and people like Gates give the lion's share of money to charity when that's completely and utterly untrue. It's a classic example of manufacturing consent.

Of course, this information tends to give people cognitive dissonance since they've been basically indoctrinated via Public Relations to believe otherwise: http://i.imgur.com/MFdTOaq.jpg

But, here's the reality:

http://www.nptrust.org/philanthropic-resources/charitable-gi...

And this here.

http://webcache.googleusercontent.com/search?q=cache:6S23Fn6...

Then, of course, there's this:

Why Don’t Corporations Give to Charity?

http://www.slate.com/articles/business/moneybox/2013/08/corp...

And finally, this:

Why the Rich Don't Give to Charity

http://www.theatlantic.com/magazine/archive/2013/04/why-the-...

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>I rather enjoyed using his products.

So do I, (at least some of Microsoft's products, anyway) including the positive influence MS has had on other products created by other companies. As I said in my first post in this thread above, Gates has also provided a lot of good in the world with his efforts in business and charity, there's no denying that and he should be commended for it (as he already is quite vociferously all over the place). But, I'm not here to parrot his Public Relations that's already disseminated nearly everywhere online and offline. Just stab in any general direction if you want to know about what a great a guy he is. I'm here to talk about his net effect on society and I am therefore presenting the side of Gates that a lot of the corporate media (and otherwise) would like to forget and whitewash in the face of his Public Relations, power and control.

Weird. I was polite, didn't insult the poster I replied to above and provided sources of evidence and my suppositions based upon said evidence.

Instead of simply downvoting me and nothing more, I would've expected other posters here to challenge my sources of evidence here at Hacker News.

Frankly, I thought most of Hackers News was better than this. I hope I'm proven right about Hacker News over time and some start backing up their downvotes with some of their own sources of evidence, etc. that disputes my own instead of simply downvoting a post they don't agree with.

You give HN too much credit. It was never a utopia, and is even less so now than 6 years ago.

That said, your parent comment isn't really a model of a great comment, either. Probably the current best example for that would be tokenadult (http://news.ycombinator.com/threads?id=tokenadult). He doesn't just dump a pile of links on us with a summary; he puts together very well-composed mini-essays that make individual points, backs up those points with references, and then puts it all together into a cogent conclusion.

You've made two really big claims that are difficult to believe: that Gates has been a net drain on society, and that he has cost the world "trillions" -- a significant portion of the US GDP. That is a lot of money. I quick-skimmed a few of your links and I don't see anything like that in them, mostly just complaints that the Gates Foundation isn't working the way the authors want it to.

Assume that we're all busy here and aren't inclined to sift through a breadcrumb trail of a couple dozen articles around the web to puzzle out how you've come to your conclusion.

There's a much more complete breakdown that's being worked on by a group of others and myself. In the meantime, I just throw some of these sources of evidence out there and quick summaries in various forums for those who are willing to initiate some of their own investigation/research.

So far, it's helped to bring a few more people onboard to help.

That said, I agree with your points that links to sources of evidence may be too challenging or time consuming for some and that's basically why the project was initiated.

>I quick-skimmed a few of your links

I think if you explore some more you'll come to see my points.

"We should teach future generations to give to charity"

We should encourage future generations to develop an alternative to the financial system that in many respects creates barriers to equality and progress in so many fields. It's tragic that eradicating a disease requires us to contribute 'tokens' to facilitate action - and if we don't contribute enough we will penalise sections of our population.

/That's my fill of financial philosophy for the week. //Time to track down that flying pig.

"He may have played loose with the rules" does not mean "I don't know if he played loose with the rules". It means "Yes, he played loose with the rules, but on the other hand..."

Thanks. I misunderstood the intent and already apologized in another post to that poster. After reading other posters here in the thread that basically mentioned sainthood, etc. for Gates, I let it color my interpretation of that post, I shouldn't have done that and I was mistaken. Anyway, apologies to all for that misunderstanding.

First, you don't understand what the sentence you quote means. For one, it doesn't mean "maybe".

Second, if you read my message thinking I was worshiping him or applying some sort of sainthood, then it is your opinion that is pre-conceived, blurred and wrong, not mine. I'm explicitly saying the man does not do it out of niceness, but because he likes (and need) to tackle a challenge and we're lucky this time he picked one that would benefit us, especially since he's one of the few than can win that one.

Third, you're greatly exaggerating the wrongs he did as CEO. Not that he did not do any or that it wasn't so bad, but he isn't the second coming of the devil either.

Take a breath.

>First, you don't understand what the sentence you quote means. For one, it doesn't mean "maybe".

When you said, "he may have played loose with the rules" I didn't take that to mean, "he played loose with the rules".

But, I misunderstood you and I apologize.

>if you read my message thinking I was worshiping him

I apologize if I misrepresented your opinion. However, I would hope that if you read back your glowing post in regards to Bill Gates one might get the impression you may not be aware of all the wrongs he did as CEO as well.

>you're greatly exaggerating the wrongs he did as CEO.

Can't say I agree with you there when one critically looks at the sources of evidence that supports my supposition:

https://news.ycombinator.com/item?id=8551072

>he isn't the second coming of the devil either.

No, he's not. Nor is he Hitler, etc. I apologize if within my short response to you I gave you the impression that I thought he was a spawn of Satan. I'm a bit more of a complex thinker than that, I think. But, I suppose I deserve that since I errantly implied you "worship" Gates. :D

Then again, I tend to get compared to Satan once I criticize Bill Gates in most forums, so I'll own it instead.

>Take a breath.

Thank you, I will. :)

"A small portion of his plunder"? The most charitable interpretation of this phrase is that you're playing a little loose with that possessive pronoun.

I've provided sources of evidence to back this up here:

https://news.ycombinator.com/item?id=8551072

If you have sources of evidence that can sufficiently contradict my own and show that Gates has been an overall net gain instead of an overall net drain for society, I'd sincerely like to review it.

No you wouldn't, and it is completely obvious. If you are willing to spend enough time to google Big Lists as big as yours, you are bound to come across counter-evidence on your own. That you are asking someone else to waste as much time as you have is sufficient proof that you are looking to silence, not evaluate.

>if you are willing to spend enough time to google Big Lists as big as yours, you are bound to come across counter-evidence on your own.

That's a very good point and I'm happy you brought it up. Although, I wish you'd been a bit more polite didn't assume bad faith with me in the process.

I've been in the process of providing a more "human-readable" (so to speak) breakdown of both the positives of his business practices, charity, etc. versus the negatives. I don't know if you've ever researched something of this scale before or not, but it takes quite a bit of time to vet sources properly and break it all down into a fair manner with methodologies that others can easily understand, relate to and, indeed, find to be a fair comparison/assessment (overall).

Despite working on this with six other people (granted, all off-and-on in our spare time since, unlike Public Relations, we aren't paid to do this), it's taken well over a year so far. Ughh..

In the meantime, I've provided sources of evidence to the public that should at the very least provoke more people to question the narrative that Gates is simply a net gain for society via his philanthropy and gains for society he created via his role at Microsoft, etc. If Gates is a Robin Hood that stole from the rich to provide for the poor, I've yet to see much data that resembles that scenario.

So far, I have measured more counter-evidence that positively reflects Bill Gates' actions than the negative evidence I've gathered (for one, it's very easy to find positives on Gates & MS). Incredibly easy... However, I've found it lacking once one considers all the costs that his monopolistic, anti-competitive behavior at this huge of a scale extolled upon society en masse along with Gates' personal hoarding of assets/money to climb towards his billionaire status to boot.

Of course, it's also complicated by the fact that Gates' assets have provided both good and bad for society as well, so it's quite complex.

But, again, if you've got some evidence that shows that Gates is an overall net gain for society after I've provided all this evidence to the contrary and I'm wrong on this, I'd like you to provide it. I'd like to review it and add it to the pile if it's not there already. Who know, perhaps you have a much better perspective I or the six others haven't yet considered.

For example, I'd like to see a better comparative analysis than what we have so far of all the jobs Microsoft destroyed versus ones they enabled internally and externally. Love to compare methodologies on that as well with more people.

Anyway, otherwise, I suppose you can just assume bad faith on my part instead of forming an argument based upon your own sources of evidence, etc.

>That you are asking someone else to waste as much time as you

That's hostile. How about you put some of that energy to good use and challenge my sources of evidence instead?

>sufficient proof that you are looking to silence, not evaluate.

I'm not looking to silence anyone at all. I very much welcome more data whether it adds to the positive gain or negative drain.

But, anyway, if that's all the "proof" you need to pre-judge my intentions, then I'm afraid we don't require the same levels of evidence to support our own suppositions in the first place, perhaps.

tl;dr - I'm still working on this with others. I'd like to see a better comparative analysis than what we have so far, so if anyone can think of some data that seriously challenges the negatives, I'd enjoy gathering it. I should also note I hope to have a final, comprehensive report completed, edited and ready for heavy rotation by Spring or earlier if we have the time and/or can get more people involved in the process. But, so far, I haven't seen anywhere near a net gain for society by Bill Gate's actions and I hope in the end we can all learn that at the very least, there's a better way to garner a successful business than hurting so many others in the process.

Thanks; this confirms my interpretation of your original comment. You're imputing the economic value of every externality you can trace to Microsoft back to Gates' own bank account. You can make that argument, but using "his plunder" as a shorthand for it is at the very least imprecise.

>You're imputing the economic value of every externality you can trace to Microsoft back to Gates' own bank account.

Not really, I'm much more focused on the externalities of Gates' anti-competitive, monopolistic business practices. His billionaire status is just a small part of the problem in comparison. Speaking of which, I am also looking at the specific assets that makes up his total net worth.

For example, as of now, Bill Gates has a net worth of nearly $82 billion, of which just $14 billion is in Microsoft stock. The bulk of the remainder is $64 billion which is invested in a variety of assets through Cascade Investment LLC, his private investment firm.

Cash, some small technology investments and assets such as his 66,000 square-foot mansion in Medina make up the last $4 billion chunk which is very small in comparison.

I've been researching how his assets both positively and negatively affect society but it pales in comparison to the bigger picture I mentioned in regards to the overall effects of his shady, past business practices that affected society globally (literally).

>You can make that argument, but using "his plunder" as a shorthand for it is at the very least imprecise.

I see your point. He certainly didn’t steal all of it and I should use a better choice of word to describe his booty. ;)

However, I was considering that he's taken far more from society than he's provided for society, so that's why I've called it "plunder", so to speak.

The final report won't have any of that kind of terminology, but as you said, it's probably better if I refrain from using it even it's simply in forum posts, etc.

Thank you for your constructive criticism.

edit: spelling/grammar

>Now he wants this terrible disease to be destroyed, and there are a lot of obstacles in his way (and after all, destroying a well entrenched virus is a feat that humanity reached only once before), but still in my heart I feel like I wouldn't bet on the virus on that one.

Correction: malaria is not a virus. It is one of 4 different species of protozoa (type of single-celled organism).

Thanks, I know very little about it and always assumed it was a virus.

Slight clarification: there are 4 COMMON species of the malaria parasite that are known infect HUMANS. Also known are around 10 rarer species that also infect humans and a few hundreds that infect other animals.

Why not advance medicine in general, moving civilization quicker up the technology curve? Won't more people benefit in the long run? Medicine doesn't advance at an exponential rate, but progress can be made more quickly.

I think what he wants to do is bring the afflicted regions up to par with what one expects from life in the western world, in terms of health. That's very important.

Well, the trick there is to create a better economy, right? The standard of living will increase then. What are the most effective ways to prevent malaria is to give people $20 nets.

$4 nets!*

http://www.againstmalaria.com/DollarsPerNet.aspx

* (plus shipping and handling)

It looks like $3.

melling@Hacker News just bought 10 nets.

http://www.againstmalaria.com/MyNets.aspx?DonationID=111536

I didn't want to round down and appear to be over-hyping.

Well done.

But his goal is to eradicate it, not only prevent it. Preventing is a step towards his goal.

I'm not at all convinced that a higher standard of living inevitably leads to lower malaria infections. I actually think the correlation is rather weak, at least in the initial part of eradicating/battling the disease.

I agree with you that controlling the disease by having a stable, efficient and proactive health care system requires a solid economy. I just don't think that's where the problem lies for the moment.

Turns out... one of the easiest ways to create a better economy is to eliminate malaria. It's that bad of a disease, that it contributes to poverty at the national level.

http://en.wikipedia.org/wiki/Malaria#Economic_impact

It's more difficult to expand and modernize your economy when a significant fraction of your population contracted mild brain damage from preventable infections.

What I think Gates is rightly targeting with his organization in a broader sense is that no matter how high the technology curve extends on the ceiling side the floor remains unaffected.

Or, to put it another way, third world countries are too poor to buy newer medical technology, and relatively few people are financially-interested in making older medical technology cheaper.

Iow, the faster/cheaper options on what to do with semiconductor process improvements.

Additionally in this case, eradication does provide a number of benefits to the global community. Even in countries with top-tier health care systems.

Letting an effective virus / bacteria / micro-organism fester in any human population isn't that different than playing Russian roulette. You may get lucky, but far better to scrub that genetic code off the face of the planet and reset the clock back to the beginning of its evolution.

Bill believes that in a couple decades there won't be many "poor" countries remaining.

Also, consider that as technology advances, prices tend to drop. For instance, it cost billions of dollars to sequence the first human genome. It will probably cost $10 in 20 years. Hopefully everyone will be able to get designer drugs.

Few people might be interested in making medical technology cheaper, but some people are trying:

http://tricorder.xprize.org

And I saw this on HN: http://www.technologyreview.com/news/532166/with-100-million...

Bill Gates could start a Y Combinator for medical companies.

There are 7 billion people on the planet now. Bringing down the cost is the only way to give everyone first-world health care.

> Why not advance medicine in general ....

I think big, specific challenges are often the best way to move useful knowledge forward. They can be enormously motivating, and they very often have positive side effects in seemingly unrelated areas.

For example, consider the Manhattan Project and the U.S. efforts to get people to the Moon. Both of these were highly focused projects. But they resulted in advancements in computing, materials science (e.g., plastics), fail-safe engineering, etc.

Or consider all the money poured into AIDS research in the past couple of decades. Results have been somewhat disappointing, but OTOH we now know a lot now about the human immune system, etc.

I would expect that a global effort to eradicate malaria would have similar wide-ranging benefits.

I agree with your points in general, but I think your point on AIDS is off. In the developed world, AIDS can be treated and managed effectively at this point to where it is essentially a long term chronic illness like diabetes. This is a huge departure from the terrifying death sentence it was in the 80s. Of course, these treatments are not accessible enough yet...

All true, but whether something is "somewhat disappointing" does depend on what expectations were. I think expectations were often pretty high in the past; however we still have no vaccine, etc.

But, yes, compared to what, in retrospect, we might call "reasonable expectations", amazing things have occurred. Around the time AIDS was first noticed, the treatment for all viral diseases was essentially do your best to keep 'em alive long enough for the immune system to fight it off. And we've certainly gone 'way beyond that with AIDS.

> Armed with this 50-cent test, community health workers with little training can determine in minutes with 99 percent accuracy whether someone has malaria or not. Last year, we deployed 200 million of them in Africa alone.

I found this statement incredible. My perspective is from someone who had a Malaria scare after coming back from Asia this summer and passing through Krakow, Poland.

I had numerous blood tests to determine whether I had malaria or not, taking hours to get the results, and even then an expert from the hospital told me they could not be sure and would need to take further tests when my fever shoots up to determine if the spores are actually there.

If we have a 50c test that has been rolled out 200 million times to Africa, I find it astonishing that a modern medical center in Poland would not have access to them.

How long ago were you in Krakow?

2 months.

Probably this is because tropical diseases are rather rare in Poland (not a big surprise). As far as I know the only place in Poland where you can find someone with practice and expertiese is Gdansk (big port in Poland) - they need to treat sailors occasionally.

It wouldn't surprise me if it is because it had not tested and licensed for EU regulations yet. Bureaucracy seems to trump common sense on these things.

From poking around reading CDC and WHO websites on malaria RDTs, they stress that since RDTs have a higher limit of detection than blood microscopy tests (which are apparently the gold standard), and also can only detect 4 common strains of malaria (at least two strains are not covered by RDTs), then negative results should (when possible) be verified by a microscopy test either way.

Given your situation then, it doesn't actually make sense to use a RDT on you. Basically, if you have what the medical infrastructure and low enough rates of malaria, you may as we just do the microscopy test all the time to ensure that you do the right treatment.

In your specific case, if they were having troubles detecting the parasite in a microscopy test, then likely they would have trouble detecting it with RDTs as well given its high limit of detection.

As someone in the US, I didn't know a whole lot about malaria, but I have read about it a little over the past few years. It isn't much of an issue here, but historically it is huge. By some estimates, half of the people who have ever died were killed by malaria. Ever.[1]

http://ngm.nationalgeographic.com/ngm/0707/feature1/text3.ht...

Eliminating malaria may or may not be possible. If you look at the work that Jimmy Carter and others have done to eradicate Guinea Worm -- reaching a low of 148 people infected in 2013, down from 3.5e6 in 2013 -- it is now primarily a political problem. The last infections are in south Sudan.

If Gates can accomplish this, eradicating malaria is a worthy coda of a life.

And on the other side, the fake vaccine drive used to locate Osama bin Laden (or at least the leaking of it) might turn out to dwarf the September 11th attacks--it may keep polio from being eradicated. Hopefully it just delays the eradication.

Back on topic: how does Gates want to address animal vectors for malaria? Nothing in the blog post.

It's one of the things that makes me wonder what useless worthless fuckwit thought that was possibly okay to do. We have enough -- and often for good reason! -- problems getting vaccines to certain countries; indisputable evidence the cia was testing identities subverts all the trust people have worked to build.

I don't think it was a fake vaccination, they just got some extra blood. However it does prove that "it's all a CIA plot" is an actual possibility.

Some charities (like MSF) are incredibly anti-political for exactly this reason. Some charities (like US AID) are not/

    > Some charities (like US AID)

US Aid is neither a charity, nor an NGO. They're a government agency, their employees go to countries on diplomatic passports, and the whole point of a government International Aid program is politics.

I should have been clear--it isn't that it was fake, it was that it caused many people in Pakistan to stop getting vaccinated.

Ah, it was a fake drive to give out vaccines, not that it was a drive of fake vaccines. If English allowed better adjective orders, we could say a vaccine fake drive.

> Back on topic: how does Gates want to address animal vectors for malaria? Nothing in the blog post.

This is only a guess, but Gates has been funding several different efforts to combat the mosquitoes themselves. One of them was something the HN crowd might appreciate: a "laser fence", an automated sentry that was remarkably able to detect mosquitoes in the air and cook them to death.

Assuming that you're referring to the "Photonic Fence" by Intellectual Ventures[1], you're actually going to get a pretty cold reception from many on HN. Intellectual Ventures and their founder, Nathan Myrhvold, are considered to be patent trolls by many HN'ers. [2][3]

[1] http://www.intellectualventures.com/inventions-patents /our-inventions/photonic-fence/ [2] https://news.ycombinator.com/item?id=1134762 [3] https://news.ycombinator.com/item?id=7090524

Not just detect mosquitos, but discriminate between the female of the particular species that spreads malaria and all other bugs.

Sadly, myhrvold.

https://hn.algolia.com/?q=Photonic+fence#!/comment/forever/0...

Should be 3.5e6 cases in 1986

Is there any way to eradicate mosquitoes completely? Are they useful for anything? They're just a huge nuisance and carriers of disease, why haven't we managed to get rid of them by now?

We're apparently pretty great at making species go extinct, just not the ones we want.

    And so, while humans inadvertently drive beneficial
    species, from tuna to corals, to the edge of
    extinction, their best efforts can't seriously threaten
    an insect with few redeeming features. "They don't
    occupy an unassailable niche in the environment," says
    entomologist Joe Conlon, of the American Mosquito
    Control Association in Jacksonville, Florida. "If we
    eradicated them tomorrow, the ecosystems where they are
    active will hiccup and then get on with life. Something
    better or worse would take over."[1]

[1]: http://www.nature.com/news/2010/100721/full/466432a.html

Mosquitoes are a food source for many animals, including: fish, birds, spiders, and bats.

Maybe those animals could find something else to eat, but there sure are a lot of mosquitoes - imagine how many get eaten.

Are you sure? An article I read said that mosquitoes are so lean that they aren't even worth the energy expenditure of hunting them.

Complete Prevention means reducing opportunities for mosquitoes to pass the parasite on to humans, and preventing the emergence of strains that resist drugs and insecticides. We’ll need next-generation vaccines that block transmission for six months to a year, so that once an area is cleared of the parasite, it stays clear. We’ll also need new insecticides to offset the widespread emergence of mosquito resistance to the chemical compounds we use most frequently today. We may even need cutting-edge approaches, like introducing special fungi into mosquito populations to kill them off or introducing modified genes that can stop mosquitoes from reproducing.

there is actually a better solution, they just have to figure out the delivery mechanism.

http://www.iflscience.com/health-and-medicine/gm-mosquitos-c...

This is a commendable goal, but I feel like it is all too tempting to focus narrowly on one disease and ignore a more holistic approach towards addressing the underlying problems. I have travelled to many countries in Africa and the big difference between countries that are sucessful in addressing malaria and others that are not are having better health systems and trained health workers. Giving out bed nets and spraying has limita. There are a lot of interesting techologies that may one eradicate malaria such as a vaccine or genetically modifying the mosquitos, but it is too short sighted when looking at the problem holistically.

Too often donors are tempted to focus on a single disease because it is much easier to measure progress and it is easier to "sell" to the public. But when you dedicate so much resources towards a single disease you're distorting the health system, and it becomes more susceptible to shocks like Ebola.

I was thinking something similar. Addressing just the disease is fine and good, but the terrible sanitation and lack of medical access issues are still there. Are those who normally going to die of malaria now going to die of something else due to environmental and social economic conditions. I guess this is how progress works. You take out the big baddies first and work your way down. The smaller baddies might also have an easier and cheaper treatment plan.

Malaria isn't a small one. Its a corrosive disease that not only reduces the ability to work, it makes you a burden on your family/community. Solve that one, there's loads more energy left to solve the others, locally.

Problems of a poor country are in vicious circle. Poverty, poor health, poor education, poor governance, ignorance all feed on each other. Of these investing in health and education give most long term benefits, of which health is most easily accepted (a dying person is more prone to accept support of strangers). Also investment in malaria, have a halo effect including awareness of hygiene, basic training for health workers.

Is his call for donation directed at specific people? I would gladly donate once I am in his position - own a house, have retirement funds etc. Which will probably take me another 30 years.

No, I think it's directed at anyone who can afford to donate, which probably includes you even though you don't own a house.

Are you seriously telling me that your life is so hardscrabble it'll take you 30 years to scrape up a spare hundred bucks or so to toss into the pot.

I am already involuntarily contributing by paying 40% tax.

My understanding was that it was impossible to eradicate Malaria in Africa because great apes could also be carriers, and treating every wild ape wasn't remotely practical.

Is that not the case?

Actually the only effective means of eradication I've ever been able to think up is an engineered virus... As it parasite it should be vulnerable to a viral weapon, and you could leave chickens with the virus in their bloodstream in Malaria infected areas.

But that could be my inner mad scientist trying to get out again.

Does anybody know, how Malario No More compares to for example Against Malaria Foundation, which was recommended as a top charity by GiveWell for a long time ( http://www.givewell.org/international/top-charities/AMF ), in terms of cost-effectiveness?

It's not that difficult. There are historical examples of freeing specific locations from malaria. I remember being told about Brijuni. http://en.wikipedia.org/wiki/Veliki_Brijun

This may be a dumb question, but are there any downsides to eradicating malaria?

While there is obviously a huge immediate benefit for humanity in doing so, is there any impact on the ecosystem, or other factors that this could upset the balance of?

Again, not saying we shouldn't eradicate it, just curious if there are any potential negative consequences.

Bill's my favorite tech entrepreneur.

Before the Gates Foundation and The Giving Pledge, billionaires usually did three things:

1. Buy fancy yachts.

2. Continue running the business that made them rich.

3. Spend a token amount on a feel-good charity. The Foundation to Prevent Euthanasia of Cute Puppies or Whatever.

Gates has managed to convince them of another option:

4. Spend wealth to alleviate large causes of suffering that few/no groups are working on.

More than 3.3 million people who would have died of malaria are alive today.

I realize he can't take full responsibility for that, but considering all he's done, Bill Gates is a living saint.

Rockefeller and Carnegie were donating vast sums of money to many different charities long ago. I wouldn't call either of their donation efforts "feel good".

I'm aware of both. I said, "usually" and I was talking about contemporary billionaires.

Both Carnegie and Rockefeller had a sense of effective philanthropy. I find it very impressive that Carnegie managed to spend 90% of his assets before he died.

Gates is comparable with Rockfeller, in the sense that they both had extremely dodgy ways of doing business and managed to create huge monopolies.

Howard Hughes? I think he wanted to the avoid taxes but his investment is still paying dividends today.

http://en.wikipedia.org/wiki/Howard_Hughes_Medical_Institute

It has a $17 billion endowment.

Actually, there are other large endowments if you look on the list.

http://en.m.wikipedia.org/wiki/List_of_wealthiest_foundation...

>More than 3.3 million people who would have died of malaria are alive today.

This does make him sound like a saint, but is number of lives saved really a good metric? I mean, what's the quality of life like for these three million people, what's their life expectancy?

I know this makes me sound like a horrible person but I think keeping extremely poor people barely alive looks good as a statistic and there's more worthy causes to spend our efforts on in those areas where malaria is prevalent.

> This does make him sound like a saint, but is number of lives saved really a good metric? I mean, what's the quality of life like for these three million people, what's their life expectancy?

You can't really be improving living conditions of people who are dead can you. So it's a first step.

More people isn't necessarily a good way to improve living conditions, however. It is pretty common for deer populations to become unhealthy when predators are removed, for example, since with no predators they just over produce and then they all starve due to lack of tree bark. You end up with a sickly, miserable population.

Then be glad that someone else did not apply this principle to you.

After all, maybe someone out there in the world thinks that 1 person / km2 ought to be enough. Who's to say that you wouldn't be in his "TO TERMINATE" list?

And these are humans you're talking about, not deer.

Oh I can assure you that the people of Africa have plenty of predators, not least of which are the IMF and World Bank.

Humans have more children to make up for the children who die. With fewer deaths come fewer births, to the point where many developed nations have a negative birth rate.

What if some of the poverty in these countries is because people die young/unexpectedly? Lots of people dying can't be good for the economy. What if curing the deaths helps the quality of life?

Heh. I predicted a comment like this would be here before I even opened the comments page. "Getting rid of malaria is nice and all, but those people will still be poor." (I also expected, "Are we really sure that saving the lives of so many people is a good idea?", but fortunately that comment isn't here yet.)

It's difficult to have much empathy for people whose lives are so far removed from our own. For most of us, cancer is the boogeyman: most of the people here have had at least one friend or relative affected by it. What would you say to someone that suggested that saving the lives of cancer victims wasn't a worthy cause?

> ...there's more worthy causes to spend our efforts on in those areas where malaria is prevalent.

You are welcome to spend your efforts wherever you like. Gates has decided to spend his efforts on malaria. There is no room for an "our" there, unless you are a significant part of the Gates Foundation. I'm grateful that the mob doesn't get to decide how Gates spends his resources.

Say that to someone whose life has been saved! You don't need to be rich to be happy. Who are you to judge the value of someone else's life?

If less children die of sickness people have less children and can feed them better.

I think this might be a moot point.

Malaria doesn't just kill. It maims. It scars families and communities. It impairs people's ability to earn. Childhood sickness inhibits the development all sorts of robustness later in life from physical strength to intellectual development. It makes certain areas underserved by public services and for profit services. It closes the doors to industries like tourism. etc. etc.

These measures aren't just extending life at the expense of quality. That's more of an advanced medicine concern.

Yeah, I spent a while hanging out in Malawi where malaria is rife and it's a nice place with friendly English speaking people but very poor to a large extent due to the malaria. If you fixed the malaria things would be much better there.

Yes, Gates believes that philanthropy can be part of solutions to alleviate social problems[1]. While most people don't agree to that, at least he is doing something one way or the other.

[1] http://www.gatesnotes.com/Books/Why-Inequality-Matters-Capit...

I don't think most people have any opinion whatsoever about how social problems can be alleviated. What makes you think they would not not believe in philantropy's effectiveness? I have never heard such a claim.

I know many people, especially in Europe, who think that while philanthropy can do good and offer assistance, only a concerted government led effort can offer any sort of permanent alleviation to social problems.

> Bill Gates is a living saint.

Maybe he just feels he has a lot to give back after what he did in the business world ?

    1. Earn shitloads by monopolistically holding 
       back a decade of innovation in the rich west.
    2. Give all of it to the poor.

If anything, that sounds like Robin Hood to me, more than anything else.

1. innovation does not only benefit the "rich west" - computers are everywhere, man.

2. I doubt he has given "all" of his fortune to the poor.

3. Robin Hood is a legend.

1. Sure thing, but if you can choose between "faster computers" and "cure malaria" then I'd wager that's pretty easy - except of course when you're called Ray Kurzweil.

> 1. innovation does not only benefit the "rich west" - computers are everywhere, man.

While this is true, the evidence so far is that innovation (at least of the kind we have been engaging in) benefits the rich far more than the poor.

> While this is true, the evidence so far is that innovation (at least of the kind we have been engaging in) benefits the rich far more than the poor.

Oh yeah ? Do you ignore the fact that even in the poorest countries people have mobile phones and connect with online services though it ? This has completely changed how they network in the past 10 years. The West is not the only harbour where innovation stops.

In many ways this was Rockefeller's motivation. He believed it was his Christian duty to earn as much money as he could and use it according to biblical principles.

Your descriptions are utterly out of whack with objective reality, and Gates's philantropy is very much in-line with Gilded Age philantropists like Rockfeller, Carnegie, Eastman or Rosenwald. Hell, Rockfeller very specifically championed and helped lead efforts against malaria (amongst many other causes).

sees author's name -> rubs eyes vigorously -> confirms that it was written by Bill Gates

"gatesnotes.com"

Why are you surprised?

Have you been asleep the last 15 years or so?

http://en.wikipedia.org/wiki/Bill_%26_Melinda_Gates_Foundati...

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